How to identify ADHD in adults

As per the guidelines for evaluating the presence of any mental disorders like ADHD for example, the Fourth Edition (DSM-IV) of Diagnostic and Statistical Manual of Mental Disorders. A person with this neurological condition may exhibit intellectual impairments and must be able to compensate and overcome few of the symptoms. Some of the ADHD symptoms may be available chronically since childhood. Since the symptoms are similar in children and adults, it is required to take an adult ADD test to confirm if the pattern of inattention and/or hyperactive impulsivity are adult ADD-ADHD symptoms. If not identified, this disorder is bound to interfere with the daily functioning of life, both at work and at home for at least 6 months.

Although the symptoms are more or less similar in children and in adults, there may be a few additional ADHD symptoms in adults. Inattention and hyperactivity are the two main characteristic signs of ADHD. For classifying ADHD according to DSM-IV manual, it is required that the symptoms of inattention and/or hyperactivity impulsivity should cause significant impairment that affects the patient’s social, academic or occupational functioning and there has to be sufficient clinical evidence for the same. Further, it should be confirmed by the psychiatrist that the symptoms thought to be of ADHD are for any other mental disorder.

1. Inattention:

• Failure to pay attention to smaller details of an issue and tends to make careless mistakes in the work or any assigned activities.
• Demonstrates difficulty to continue to pay attention even in small tasks or play activities.
• Lacks concentration and seems like he is not listening to someone who is speaking.
• Inability to follow the given instructions throughout the completion of the assignment and often fails to finish the assigned chores or duties at workplace.
• Faces difficulty to keep himself organized or seems to be much unorganized with his jobs and activities.
• Tries to avoid activities which require significant mental effort or involves thinking. Expresses dislike or reluctance to participate in such tasks.
• Mostly tends to lose things that are necessary to perform the assigned tasks or activities, e.g., stationary and files.
• Can be easily distracted by external factors.
• Always forgetful of basic things and activities that are required to be performed regularly.

1. Hyperactivity-impulsivity:

• The person tends to fidget a lot with his hands or feet. In some cases, he will be unable to sit properly and squirms in seat.
• Will be restless while asked to sit in a place and leaves the seat in situations in which he/she will be expected to remain seated.
• Finds difficult to remain focused or quiet or stay engaged in leisure activities or a normal conversation.
• This person is always “on the go” and restless to stay in one place for too long.
• Talks excessively and non-stop and doesn’t stick to one topic of discussion. Keeps jumping conversations and interrupts or intrudes when others are talking.
• Often reacts even before a question has been asked or an activity has been completed.
• Lacks patience to wait for his/her turn.

Although the symptoms of ADHD that cause impairment have an onset before age 7, this age is considered to be very restrictive for diagnosis. Psychiatrists will find it very difficult to diagnose this condition in adults as it would be difficult to accurately recall what happened in childhood as early as 7 years of age. Hence, the doctors generally try to analyze based on the symptoms that would have existed between ages 7 and 12. For example, the common tendency of inattentiveness in a young kid who did not demonstrate any disruptive behavior must have not had any signs of impairment until middle school or high school. The severity of the symptoms should be considered before classifying the level of disorder. The DSM-IV manual mentions about three subtypes of ADHD. Based on the type and severity of symptoms, ADHD is classified into three subtypes. As these symptoms may change over a period of time and hence called ‘presentations’ rather that subtypes. The three subtypes are as follows.

1. Predominantly Inattentive Presentation: As the name suggests, the symptoms of inattentiveness will be predominant in these patients. Individuals find it difficult to stay organized or to finish a task due to lack of attention and get easily get distracted.
2. Predominantly Hyperactive-Impulsive Presentation: These people are very fidgety and very talkative. They are very restless and have trouble sitting in a place for too long or to wait for their turn.
3. Combined Presentation: These persons demonstrate symptoms of both the above types of presentations.